Failure Rate and Side Effects of Hormonal Methods of Menstrual Suppression in Hajj Pilgrims in Kerman Province, 2023: A Cross-Sectional Study

Document Type : Original Article

Authors

1 M.Sc. Student of Midwifery, School of Nursing and Midwifery, Rafsanjan University of Medical sciences, Rafsanjan, Iran.

2 Instructor, Department of Midwifery, Geriatric Care Research Center, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

3 Associate Professor, Department of Midwifery, Geriatric Care Research Center, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

4 Associate Professor, Department of Psychiatric Nursing, Social Determinants of Health Research Center Rafsanjan, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

10.22038/ijogi.2025.82574.6211

Abstract

Introduction: According to religious guidelines, women are exempt from performing certain Hajj rituals during menstruation. Identifying an effective method for menstrual suppression with minimal side effects is a significant concern for women of reproductive age during Hajj. This study was conducted with aim to investigate the failure rates and side effects of menstrual suppression methods among female pilgrims from Kerman province during Hajj Tamattu.
Methods: This descriptive cross-sectional study was conducted in 2023 on 537 female Hajj pilgrims aged 11–54 years from Kerman province. Demographic data, menstrual suppression methods, and related side effects were collected using a checklist and telephone interviews. Data analysis was performed using SPSS software (version 22) and one-way ANOVA, Tukey, Chi-square, and Fisher’s exact tests. P<0.05 was considered statistically significant.
Results: The most commonly used menstrual suppression methods included: LD pills (33.2%), megestrol (17%), Primolut N (15.4%), Yasmin (8.9%), GnRH agonists (7.7%), Cyclofem (0.8%) and three-month injections (0.8%). The highest failure rates were observed in megestrol users, with (26.2%) experiencing menstruation (p=0.003) and 15 (35.7%) reporting spotting (p=0.026). Overall, 100 (40.5%) of women reported side effects, with bleeding and spotting being the most common. Satisfaction scores were significantly lower for megestrol users compared to GnRH agonist users, while no significant differences were observed among other methods.
Conclusion: The study demonstrated that GnRH agonists were associated with the lowest failure rates, minimal side effects, and the highest satisfaction among hormonal menstrual suppression methods.

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Main Subjects

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 5
July 2025
Pages 49-58

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